Claims Customer Service Advocate

For those who want to keep growing, learning, and evolving. We at Kelly® hear you, and we’re here for you! We’re seeking a Claims Customer Service Advocate II to work at a leading healthcare organization in Myrtle Beach, SC. Sound good? Take a closer look below. You owe it to yourself to consider this great new opportunity.

Salary/Pay Rate/Compensation: $17.75 per hour

Shift: 8:00am to 5:00 PM

Credit Check REQUIRED

• Competitive pay rate with opportunities for overtime.
• Work with a reputable organization in the healthcare industry.
• Gain experience in claims processing and customer advocacy.
• Positive, professional work environment focused on growth and development.
• Opportunity to expand your expertise in customer service and healthcare claims.

• Responding to customer inquiries via phone, written correspondence, web, or in-person, including non-routine inquiries requiring deviation from standard procedures.
• Researching and resolving customer inquiries to ensure effective and timely resolutions.
• Reviewing and adjudicating claims and/or non-medical appeals, determining whether to return, deny, or pay claims in alignment with organizational policies.
• Processing claims adjustments and reprocessing actions following department guidelines.
• Entering claims into the system after verifying correct coding of procedures and diagnosis codes.
• Ensuring claims are processed according to quality and production standards.
• Referring complex complaints and inquiries to a lead or manager when necessary.
• Identifying and reporting potential fraud and abuse situations.

• Have previous experience in customer service, preferably in a healthcare or insurance environment.
• Are comfortable handling complex inquiries and performing research to resolve issues.
• Possess strong communication skills and a commitment to providing courteous, accurate, and timely responses.
• Demonstrate attention to detail and the ability to follow department guidelines and procedures.
• Are able to identify and elevate issues appropriately.
• Are available to work 1st shift hours.

As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources.

Please note:

The following benefits reflect Kelly's general offerings. Eligibility may vary by assignment, location, and job type. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account.

In addition, employees are entitled to earn paid sick leave under the applicable state or local plan.

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